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Full text of "Registration under the Canada Medical Act [microform]"

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Cwwdiafi Inatitiin for Hhtorical MIerorapraductiaM / InstHut Canadian da microraproduetiona hiatoriqiiaa 




1995 



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REGISTRATION UXDEF THK C\\ADA ' 

MEDICAL T ♦ : ■; 

• Read at the Tenth Annual Conte • of the Council on Medical 

Education, Chicago, Feb. 24, 1914. 



I^ 



R. W. POWELL, M.D. 
Reiittrar of the Medical Council of Canada 
OTTAWA, 0.\T. . 



Allow me in the first place tj express my appre- 
ciation of the compliment extended to me in giving 
me this opportunity of addressing this distinguished 
gathering of educationalists. I fully realize that it 
is the oflFice I hold that has singled mc out for this 
distinction, hut nevertheless, I feel tha' you will 
pardon my humble pride when I tell vou that this 
scheme of "Dominion Registration" lias for many 
years been very dear ti. my heart and that in 
season, and out of season, I have forwarded the 
measure to the limit of my capacity, and now when 
I find that within eighteen months of its fruition 
I am here in the flesh to amplify its measures to 
my colleagues of this great Republic, I feel a sense 
of gratification not measurable in words. 

Since the birth of the Dominion of Canada in 
1867 -the profession of medicine has never once lost 
sight of the unfortunate position it was placed in 
by reason of certain clauses of the British North 
America Act, which placed matters afTecting educa- 
tion under the control of the Provinces. It is fairly 
clear that such was not the absolute intention of 
the framers of that Act ; but rather that what was 
intended to be included was matters of ordinary 
or common public education, and from that day to 
this the Provinces have held out stoutly for what 
they honestly believed were their rights under the 
constitution. 



, yy^ With the birth of the Dominion came the birth 
I ■ of the Canadian Medial Association, and at its 

first session in Quebec in 1867 under the presidency 
of Dr. Tupper, now the veteran Sir Charles Tupper. 
the question was introduced and discussed and a 
Bill was actually framed about two years later to 
test the question in the Canadian Parliament. So 
many obstacles appeared to be in the way that the 
scheme was dropped, so far as the active political 
leaders were concerned. When I mention that Sir 
Charles Tupper, a prominent member of our pro- 
fession in his day, and a prominent and leading 
politician as well, felt that the scheme for a Federal 
Act was out of the question, you will realize that 
serious difficulties must have been on the horizon. 
Sir Charles was not a man to be daunted by trifles, 
and he was always the embodiment of loyalty to 
our profession. 

I may add that years afterward (in the early 
eighties) I personally went into the matter with 
him, only to be told that the one and only way 
to accomplish our desires was by first securing an 
amendment to the British North America Act in 
the Imperial Parliament at Westminster— many of 
my hearers must know what a herculean proposi- 
tion this would entail. 

Our profession, always hopeful, and never pessi- 
mistic, kept on bringing the question to the notice 
of the general body of practitioners as represented 
by the Canadian Medical Association. From the 
time I joined the Association in 1879 the point has 
never once been lost sight of, and it came about 
that the great mass of practitioners, constantly 
increasing in numbers and influence, became gradu- 
ally permeated with a desire for some general 
scheme that might be called an interprovincial reci- 
procity, or, roughly, a breaking down of imaginary 
barriers so far as active practice was concerned. 



Committees were formed and discussions took place 
annually, but all to no purpose. It would appear 
that we were seeking the solution of an impossible 
situation. 

The growth of the Dominion, the addition of new 
Provinces, the establishment of new borders, all 
tended to tighten the rein, and the barriers became 
strengthened rather than weakened. 

Equalization of standards and the creation of 
examining boards with corresponding similarity of 
ideals must be the precedmg elements to inter- 
provincial reciprocity. Then again, certain Univer- 
sities had acquired charter rights from the Crown 
extending to all faculties, and this became a bar 
not easy to surmount in some quarters. 

I must now digress for a moment to say that at 
a most opportune and auspicious moment a patriot 
and a prophet arose in our country, and to him 
was given a roving commission by the Canadian 
Medical Association to inaugurate a scheme for the 
establishment of a Medical Council for Canada. I 
refer, of course, to Dr. T. G. Roddick of Montreal, 
late dean of the faculty of medicine of McGill. To 
say that Dr. Roddick threw his whole soul into this 
work would but feebly express my thoughts and 
his untiring services. He devoted his time and his 
money, as well as his energy, to it and in 1896 
actually sought and obtained a seat in Parliament 
iti order to be in a still stronger position to forward 
his measure. Could human devotion and enterprise 
go further than this ? It necessitated hard work, 
much patience and diligence, as well as a refined 
diplomacy of a high order. Unbounded pluck and 
perseverance came to his assistance. He travelled 
the length and breadth of Canada on three separate 
occasions, met all the Provincial Councils, sympa- 
thized with them, argued with them, persuaded 



them to rise above provincialism ; and while all 
this was going on he never lost an opportunity of 
bringing his scheme to the notice of the profession 
at large. It is gratifying to us all to know that 
his work has been appreciated and that on its con- 
summation in November, 1912. he was unanimously 
elected the first President of the Medical Council 
of Canada by acclamation. 

I most sincerely wish that he could have been 
here to-day to enter into the spirit of this meeting 
and to take my place on this platform by addressing 
you, but it was not ])t)ssible. He begs nic, however, 
to assure you that he is thinking of this meeting 
to-day and that while he cm only send his benedic- 
tion, his hopes and wishes are for the highest 
fruition of your endeavours, and that they will be 
crowned with a result that will stand for what is 
highest and best. 

The history of the passing of the Canada Medical 
Act can now be tol<l without trespassing too long 
on your patience. I may say that the pivotal points 
of the Act were few. Certain great principles had 
to be kept in mind, and possibly if I take these up 
seriatim I can the better elucidate what has hap- 
pened. 

I have told you that the Provinces of our Domin- 
ion had certain charter rights specifically granted 
to them, and it was provided that as new Provinces 
were carved out and given a constitution by the 
Canadian Parliament, at Ottawa, these charter 
rights were to be automatically extended. One of 
these was education, and so it came about that each 
Province has from time to time passed certain laws 
regarding the admission of men to the license to 
practise medicine. Certain bodies, outside what 
we know as the regular profession, had also secured 
rights for their adherents. 

4 



It is tvideiit now that tin- Parliament of Canada 
could not pass laws that would contravene the 
I'ronncial rights, and I may say that on many occa- 
sions the framers of the C'ana('- Medical Act were 
confronted with this awftd hufjhe:. ' It was thou,L,dit 
by some that beneath the worditif,' of the Act tlierc 
must be some sinister innnence hirkinj,' that woulil 
in some way undermine their privilejfes. It was 
not really so, because the Canada Medical Act 
to-day docs not take away a sin^jle ri^dit of the 
I'rovinco. albeit some years were required U> be 
spent to estal)lish the ar},'ument. 

The first point then is that the h'ederal Act con- 
stitutes a body known as th? Me<lical C.ntncil oi 
Canada, K'vin}j it priwers to create an examininj,' 
board, and to establish a Medical Kej,'ister for 
Canada. The next point was that the standard to 
be fixed by the Council, the passing of which would 
entitle the candidate to be enrolled on the Register, 
was at all times to lie at least as high as that 
obtaining in any Province of the D(miinion. If the 
Council allows the standard to fall below a certain 
plane, and excei)tion is thus taken to the Act by 
an aggrieved Province, there is provision in the 
Act for a tribunal before which the matter is to 
be heard and settled. 

The next point was the composit'on of the Coun- 
cil. This really gave rise to much controversy 
owing to the uncqu.-'I distribution of medical men 
in the various Provinces and to the fact that if 
so-called justice was to be done, as regards represen- 
tation by population, the C.uncil would be r.n un- 
wieldy, ciiml>ersome body with its efTicicney pro- 
portionately reduced. It was kept in mind that 
in this great country where I am speaking to-night 
the small State of Rhode Island has representation 
m the Senate equal to her sister States. I submit 
this subject to correction. 



To leave (Mtt pages of discussion and aiKiiment. 
n basis vas (mally arrived at as follows: Each 
Province of the Dominion throuRh its Medical 
Council is entitled to send two representatives to 
the Council, and they are to he appointed, or elected, 
in such manner as ttie particular Provincial Medical 
Council may hy hy-law enact. 

Then, each University having a teaching faculty 
of Medicine, or Medical School having University 
affiliations for granting degrees in Medicine, is 
entitled to send one representative. 

The Homeopathic body, which has certain rights 
in the Provinces, is considered as a whole, and 
they elect three representatives from their adher- 
ents in Canada. 

'n order to cement this body and give the Govern- 
m<;nt of Canada a voice in the conduct of its affairs, 
and to make it more or less an advisory body, if 
need be. to the Canadian Government, the Governor 
General in Council (which is the Dominion Cabinet) 
has the right to send three representatives. On 
this point it is provided further, that as certain of 
our Western Provinces have not as yet University 
representation, and until they do have it by virtue 
of the creation of faculties having degree-conferring 
powers in Medicine and Surgery, two of the three 
government appointees must be selected from one 
or other of the said Western Provinces to distribute 
as equably as may be the total body of the Council 
over the entire Dominion. 

.•\nother point was that the Medical Council of 
Canada was to have nothing to do with matricula- 
tion, or preliminary education. The framers of the 
Act immediately conceded that this was eminently 
fair and in the spirit of the British North America 
Act. 

Another important point, which followed naturally 
from the foregoing, is that holders of foreign diplo- 



i 



mas must present ci-rtificatrs similar, or i'(iiial to 
those required from ' 'ana<liaii (jraduates. 

Tliis was necessary in order tliat the I'rovincial 
authorities, who must sifjn the certificates of those 
applying to come up for the Medical Council of 
Canada examinations, and wh'i are not as yet 
licensed practitioners of any Province of Canada, 
can satisfy themselves on all points as to whether 
the candidate has fulfilled all the requirements, in- 
cluding preliminary education an<l matriculation 
and the course of stu<ly siiUscqucntly. 

A difTicult question arose in considering the status 
of those who were already licensed in some Pro- 
vince when the .Act came into force. It was felt 
by certain Provinces that it would possibly be to 
their detriment if the whole body coul receive 
Dominion Registration by paying the fe( hen the 
Act came into force and so receive registration in 
any Province if they so desired. It was decided 
that a fixed time should be settled for a man to 
have been licensed before he could thus take ad- 
vantage of the Act. It was pointed out that if a 
man had been six or seven years practicing in a 
given locality, he would be more likely to have 
formed alliances, and be more or less rooted in his 
habitat, and that growiiig Provinces would there- 
fore not be liable to a stampede. .After prolonged 

I discussion and negotiation this period was fixed at 
ten years. Therefore, when the Act came into 
force, those who had been licensed prior to that 
particular date, and had been ten years so licensed, 
could apply for and o])tain Dominion Registration 
by paying the fee and complying with certain or- 
dinary regulations. This so-called "ten-year clause" 

. goes on for all time and applies to all who were 
licensed to practise in Canada prior to \ov. 7, 1912. 
Thus, if a man was licensed in 1904 he can obtain 
Dominion Registration under this clause when ten 



years have expired from the date of his registration, 
namely, 1914, and so on. 

The result of this will be that the ten-year clause 
will be taken advantage ci more largely in the first 
few years of its operation than later, and after ten 
years have elapsed there will be only a few men 
seeking registration by ihis means, because the 
natural law is always operating and cannot be legis- 
lated away, namely, that we are growing older. 

I now come to my final paragraph and about 
this there was much discussion and argument : At 
what date was the Act to come into force ? Leav- 
ing aside much detail of interesting argument, it 
was finally settled in the Act that it was not to 
become operative, but was more in the nature of a 
permissive Bill, till all the Provincial Legislatures 
had legislated in etTect that they agreed to its pro- 
visions, and had so amended the Medical Act of 
the Province that it provided that if A. B. pre- 
sented himself to the Registrar of the Province, 
holding a certificate that he is enrolled on the 
Medical Register of Canada, he is entitled to be 
registered on the Register of the Province as a 
licensed practitioner by complying with the ordin- 
ary regulations in that behalf, such as paying the 
established required fee, etc., etc.